| Dr Phillip O Ajayi, MD | |
|
455 S Main St Ste 101, Hinesville, GA 31313-4354 | |
| (912) 876-6868 | |
| (912) 876-6566 |
| Full Name | Dr Phillip O Ajayi |
|---|---|
| Gender | Male |
| Speciality | Pediatrics |
| Location | 455 S Main St Ste 101, Hinesville, Georgia |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366769622 | NPI | - | NPPES |
| 300039155A | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208000000X | Pediatrics | 49871 (Georgia) | Primary |
| Entity Name | Pedsnow Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1427616515 PECOS PAC ID: 6305281429 Enrollment ID: O20240228004030 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Phillip O Ajayi, MD 455 S Main St, Ste 103, Hinesville, GA 31313-4354 Ph: (912) 876-6868 | Dr Phillip O Ajayi, MD 455 S Main St Ste 101, Hinesville, GA 31313-4354 Ph: (912) 876-6868 |
Dr. Nicole Stack Broerman, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 462 Elma G Miles Pkwy, Hinesville, GA 31313 Phone: 912-369-9400 Fax: 912-877-9438 | |
Kijana Nicola Nix, MD,FAAP Pediatrics Medicare: Medicare Enrolled Practice Location: 455 S Main St Ste 103, Hinesville, GA 31313 Phone: 912-408-6868 Fax: 912-876-6566 | |
Mary Judith Allen, D.O. Pediatrics Medicare: Medicare Enrolled Practice Location: 303 Fraser Dr, Hinesville, GA 31313 Phone: 912-877-2227 Fax: 912-877-2332 | |
Eric Lee Hall, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 512 S Main St Ste A, Hinesville, GA 31313 Phone: 912-369-5437 Fax: 912-369-5740 | |
Douglas A Boudreau, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 303 Fraser Dr, Hinesville, GA 31313 Phone: 912-877-2227 Fax: 912-877-2332 | |
Mrs. Lisa S Elkin, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 455 S Main St Ste 105, Hinesville, GA 31313 Phone: 912-876-0250 |